by Caroline Fife, M.D. | Oct 16, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests, CTP / Skin Substitutes
Alexandra Gehrke and her husband, Jeffrey King of Arizona pleaded guilty to over $1.2 billion of false and fraudulent Medicare and other insurance claims for, “expensive, medically unnecessary wound grafts that were applied to elderly and terminally ill patients.” The...
by Caroline Fife, M.D. | Oct 13, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests, CTP / Skin Substitutes
Eastern District of California | Fresno County Podiatrist and Sales Representative Plead Guilty to Conspiracy to Submit False Claims Related to Skin Grafts | United States Department of Justice US Attorney Eric Grant has announced that Felipe Ruiz, a podiatrist at...
by Caroline Fife, M.D. | Aug 20, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests, CTP / Skin Substitutes
I recently reviewed with interest the press releases and case summaries issued by the Department of Justice (DOJ) related to individuals charged in the 2025 National Health Care Fraud Takedown for their involvement in the “skin substitutes” space.““` With...
by Caroline Fife, M.D. | Jul 1, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests, CTP / Skin Substitutes
In yesterday’s press release, the specific mention of the abuse of “skin grafts” (sic) is from minutes 4:50 to 5:31 Excerpt from remarks by Matthew Galeotti, Head of the Department of Justice (DOJ) Criminal Division, June 30, 2025: “Many of the defendants charged as...
by Caroline Fife, M.D. | Jun 30, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests, CTP / Skin Substitutes
Today the Department of Justice (DOJ) held a press conference which was led by Dr. Mehmet Oz, the Administrator of the Centers for Medicare and Medicaid (CMS) and officials from the DOJ, announcing the results of its 2025 National Health Care Fraud Takedown. The...
by Caroline Fife, M.D. | Jun 27, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests, CTP / Skin Substitutes
The Houston Chronicle has reported that a Houston podiatrist and his business partner have been charged with $45 million in healthcare fraud in relation to the billing of bioengineered skin substitutes Dr. David Jenson and Nestor Refael Romero Magallanes are...
by Caroline Fife, M.D. | Feb 24, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests
Check out Jeanne Pinder’s latest article about skin substitutes on Clear Health Costs! Caroline Fife, M.D.Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog...
by Caroline Fife, M.D. | Feb 3, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests, CTP / Skin Substitutes
Office of Public Affairs | Arizona Couple Pleads Guilty to $1.2B Health Care Fraud | United States Department of Justice The Department of Justice (DOJ) office of public affairs has announced that on October 24, 2024, Alexandra Gehrke pleaded guilty to conspiracy to...
by Caroline Fife, M.D. | Jan 31, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests
A lot is being said about the way that the new LCD(s) around Cellular Tissue Products (CTPs) / skin substitutes might impact access to care. A big issue is around product choice and ensuring that there is a large enough suite of covered products from which physicians...
by Caroline Fife, M.D. | Jan 13, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests
The CGS J15 Contractor Medical Directors have given me permission to share the slide deck that was presented on December 20th, which was a training session on the upcoming “skin sub” LCD. This PDF of the slide deck reviews the LCD requirements for the treatment of...